Provider Demographics
NPI:1336332873
Name:CARLSON, CYNTHIA RHEA (RDH)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:RHEA
Last Name:CARLSON
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7807 RED OAK RD
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68516-6311
Mailing Address - Country:US
Mailing Address - Phone:402-489-9598
Mailing Address - Fax:
Practice Address - Street 1:7807 RED OAK RD
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68516-6311
Practice Address - Country:US
Practice Address - Phone:402-489-9598
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-18
Last Update Date:2007-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE358124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist